Provider Demographics
NPI:1669544409
Name:BOKSZCZANIN-KNOSALA, ALEKSANDRA DOROTA (MD)
Entity type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:DOROTA
Last Name:BOKSZCZANIN-KNOSALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEKSANDRA
Other - Middle Name:DOROTA
Other - Last Name:BOKSZCZANIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1800 HARRISON ST FL 7
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3466
Mailing Address - Country:US
Mailing Address - Phone:510-625-6262
Mailing Address - Fax:
Practice Address - Street 1:260 INTERNATIONAL CIR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1130
Practice Address - Country:US
Practice Address - Phone:408-972-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51352207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C513520Medicaid
00C513520Medicare ID - Type Unspecified
CA00C513520Medicaid